Effect of standardised surgical assessment and shared decision-making on morbidity and patient satisfaction after breast conserving therapy: A cross-sectional study

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Effect of standardised surgical assessment and shared decision-making on morbidity and patient satisfaction after breast conserving therapy : A cross-sectional study

Aristokleous, Iliana (author): Uppsala universitet,Plastikkirurgi,Uppsala Univ Hosp, Dept Surg, Endocrine and Breast Unit, S-75237 Uppsala, Sweden.

Öberg, Johanna (author): Uppsala Univ Hosp, Dept Surg, Endocrine and Breast Unit, S-75237 Uppsala, Sweden.;Uppsala Univ, Fac Med, Dept Surg Sci, S-75236 Uppsala, Sweden.

Pantiora, Eirini (author): Uppsala universitet,Endokrinkirurgi,Uppsala Univ Hosp, Dept Surg, Endocrine and Breast Unit, S-75237 Uppsala, Sweden.

Sjökvist, Olivia (author): Uppsala universitet,Plastikkirurgi,Uppsala Univ Hosp, Dept Plast & Maxillofacial Surg, S-75237 Uppsala, Sweden.

Navia, Jaime E. (author): Uppsala universitet,Institutionen för kirurgiska vetenskaper,Uppsala Univ Hosp, Dept Surg, Endocrine and Breast Unit, S-75237 Uppsala, Sweden.

Mani, Maria (author): Uppsala universitet,Plastikkirurgi,Uppsala Univ Hosp, Dept Plast & Maxillofacial Surg, S-75237 Uppsala, Sweden.

Karakatsanis, Andreas (author): Uppsala universitet,Endokrinkirurgi,Uppsala Univ Hosp, Dept Surg, Endocrine and Breast Unit, S-75237 Uppsala, Sweden.

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Elsevier, 2023
2023
English.
In: European Journal of Surgical Oncology. - : Elsevier. - 0748-7983 .- 1532-2157. ; 49:1, s. 60-67

Related links:: https://doi.org/10.1...; show more...; https://uu.diva-port... (primary) (Raw object); https://urn.kb.se/re...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

Background: The role of oncoplastic breast conserving therapy (OPBCT) on physical function, morbidity and patient satisfaction has yet to be defined. Additionally, technique selection should be individualised and incorporate patient preference. The study aim was to investigate differences between "standard" (sBCT) and oncoplastic breast conservation (OPBCT) in patient-reported outcomes (PROs) when patients have been assessed in a standardised manner and technique selection has been reached through shared decision-making (SDM).Methods: This is a cross-sectional study of 215 women treated at a tertiary referral centre. Standardised surgical assessment included breast and lesion volumetry, definition of resection ratio, patient-related risk factors and patient preference. Postoperative morbidity and patient satisfaction were assessed by validated PROs tools (Diseases of the Arm, Shoulder and Hand-DASH and Breast-Q). Patient experience was assessed by semi-structured interviews.Results: There was no difference of the median values between OPBCT and sBCT in postoperative morbidity of the upper extremity (DASH 3.3 vs 5, p = 0.656) or the function of the chest wall (Breast-Q 82 vs 82, p = 0.758). Postoperative satisfaction with breasts did not differ either (Breast-Q 65 vs 61, p = 0.702). On the individual level, women that opted for OPBCT after SDM had improved satisfaction when compared to baseline (+3 vs -1, p = 0.001). Shared decision-making changed patient attitude in 69.8% of patients, leading most often to de-escalation from mastectomy.Conclusions: These findings support that a combination of standardised surgical assessment and SDM allows for tailored treatment and de-escalation of oncoplastic surgery without negatively affecting patient satisfaction and morbidity.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)

Keyword

Breast cancer
Breast conservation
Upper -extremity morbidity
Patient -reported outcomes
Patient experience
Shared decision -making
Oncoplastic surgery

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By the author/editor: Aristokleous, Il ...; Öberg, Johanna; Pantiora, Eirini; Sjökvist, Olivia; Navia, Jaime E.; Mani, Maria; show more...; Karakatsanis, An ...; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

Articles in the publication: European Journal ...

By the university: Uppsala University

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